It is normal to develop a mild thickening of the skin around the rim of the heel as this area experiences a lot of pressure and the skin would suffer if it was too fragile. Sometimes this skin becomes excessively thick which can cause it to splitthrough to the good skin below, bleed and be very painful.
Split heels can also be unsightly as dirt gets imbedded in the grooves and can t be washed out. Spouses often complain that either the bed sheets get torn or that their own shins get brutalised during the night! Several things can cause this problem to occur. Most often it is a simple matter of skin type and often runs in families. Abnormal pressure distribution or neurological conditions can contribute. Whatever other factors are involved, it is certain that walking barefoot or in backless shoes / thongs makes things worse as it lets the skin dry out more.
Why don t they go away? The thickened top layer of the skin is dead and therefore has no potential to heal any cuts or splits etc. Once it is damaged it cannot repair itself. There is a big blob of fibrous tissue that sits under the heel bone when you are not standing on it. When you bear weight, this tissue bulges out to the side. As you walk, this leads to the cracks constantly opening and closing as the heel pad changes shape with each step. Where the skin has a fault line (i.e. the split), the good skin below it is under a lot of stress and will open up and bleed which is very painful. When it heals, the pain goes but the crack in the dead skin persists and the cycle repeats.
What can be done about it? Fortunately, the treatment is simple, effective and painless. Knowing that the skin is dead also means that it doesn t have any nerves and can be removed by the podiatrist painlessly, like a hair cut. If the problem is mild, that may be all that is required. If the cracks go too deep, you might need a two part cure, with the second appointment around 3 weeks after the first. If you haven’t already bought heel ointment, hold off until seeing the podiatrist as most commercial preparations are very greasy and pose a slip hazard as well as being time consuming to apply. The podiatrist will also teach you a taping method that will stop pain straight away if another split should occur.